Urinary catheters are well known devices that allow medical professionals to access targeted sites within a patient's urinary tract. Depending upon the particular procedure to be performed, the urinary catheter can facilitate the delivery of treatment devices or medicants or can provide a drainage function whereby fluid can be removed from the urinary tract. One procedure in which a urinary catheter can function to both deliver treatment devices and provide for fluid drainage is in a radical prostatectomy in which a surgeon removes all or most of a patient's prostate. Because the urethra travels through the prostate immediately before reaching the bladder, the upper part of the urethra is removed in the surgery. The procedure leaves a severed urethral stump and a severed bladder neck. To restore proper urinary functions, the bladder and the urethra must be reconnected.
Conventionally, a surgeon may execute delicate suturing operations with tiny, fine needles to reconnect these anatomical bodies. Installation of sutures, however, with a needle, to connect the severed tissues, can be a difficult and often technique-sensitive task. Many factors can make this task difficult, including a very small amount of tissue to work with (at the urethral stump and at the bladder neck), proximal ureters at the bladder, and a proximal nerve bundle and sphincter at the urethral stump. All of these add up to a complicated and delicate suturing procedure that, if not performed properly, could result in complications such as leakage, difficulty in healing or failure to heal, incontinence, or impotence. Specific problems include necrosis of the sutured tissues; stricture of the urethra, which can impede the flow of fluid through it; and a urethra-bladder connection that is not fluid-tight. In addition, methods of suturing the urethra to the bladder allow for accidental or inadvertent piercing of the nearby neurovascular bundle, which can cause incontinence or impotence.
In order to overcome the problems associated with suturing during conventional prostatectomies, catheter-based anastomosis devices have been developed to provide a means by which the severed urethral stump and a severed bladder neck are retained and approximated throughout a healing period. These catheter-based anastomosis devices are available from American Medical Systems of Minnetonka, Minn. which is the assignee of the present application. Representative configurations and elements of these catheter-based anastomosis devices are described and illustrated within United States Patent Publication Nos. 2011/0118767, 2011/0288570, 2011/0295287 as well as U.S. Pat. Nos. 7,717,928, 7,771,443 and 8,066,725, all of which are herein incorporated by reference in their entirety.